The Last Song

I still must have run about butt-naked for all that I care, but that was a long time ago. It was the time when my grandmother was still alive and told me tales of the wondrous days of her youth. I can swear she did sing me a few songs when she'd find it hard to describe but for the life of me, I didn't remember a single word of the songs or what it was all about. But that was not the last time I heard those songs.

Now almost 20 years later, I’m scouring the internet for one of those songs (don't you wanna frown at the irony here -learning/looking for our traditional song in the internet!) for reason which I should have foreseen and which people have every right to expect of me.

See my sister who studies in Norway called me about her peculiar problem. "I have the perfect dresses (traditional) but what am I suppose to do about the traditional song or dance" she moaned. For all that I care she can sing one of those Lengtong Pauno's, but it did bug me that I myself didn't know a single line of those song, which people identified with me as my traditional song.

I remember, as a kid, our yearly sojourn to either one or the other of our aunts' village during the harvest festival. my parents would hardly approve of us going for the simple reason that there were free flow of alcohol but not wanting to offend any of the aunts, they would sent us packing without them hardly ever accompanying us. As the youngest in my family, I do feel lonesome, but anticipating for the festival in itself was a treat!

I remember, seeing men and women, young and mostly old, sitting around the hearth, or dancing along in circle in the big porch or court-yard, and throwing those songs at each other in anticipation of a reply. The reply did come every time and the song and dance would continue - the beat of the drums and the shrill but melodious voices mesmerizing the quaintly dead night in to a full bright morning.

Then I remember listening to, as a kid, the Smokies and the Eagles, the McKameys, etc, and while growing up came the Back-street Boys, MLTR, the Gaither Homecoming Friends, Avril Lavigne, Leeland, Sugarland, et al. They have entertained me and mesmerized me like any songs is suppose to do... And if I needed to express myself, I got a diary and a blog to express myself! I don’t need to twist and reverse words and sing it in monotone to express anything!

See I never needed the song! Am I still who I am since I didn't know and can't sing any of those so called 'traditional' song? A man without a leg is still a man, right? But then why do I write all this stuff about a stupid song if I don’t so much as care about it? Or is it really that stupid? And don’t I care?

But the truth is, I do care and it bugs me that I don't know any of those songs and can't sing even a single line. It is like a little stain in your favourite white shirt that people hardly notice but spoiled the cloth for you!  Every time you looked at the cloth, you see the big (actually tiny-little) stain!

So for the sake of me, I downloaded those songs and practiced a few of them. I have never got the chance to sing or show-off. And when I do sing it, will it be the last song? I have this idea of force feeding my children (when I have them) with these songs. But how long will the song survives -especially when it is faced against the like of Lady Gaga and Justin Bieber?

The honest truth is, those traditional songs are dying... we can accept that fact or make plans to revive them by singing them in our daily life, in our churches, and re-packaging them in a different avatar! But then, that's not case now.

Another truth is, we had more advance and stylist way to express our feelings and emotions, we no longer need to sing each other a song... we just make a simple phone call. Those songs were supposed to be expressed and came from the heart only and are very special - just like my diary.

The final truth is - the last song had been sung and we don't know when! Another song will not be sung again simply because we don't know how to!

Psychosocial Impact of Disaster and Social Work Intervention With Survivors

(This is part of my assignment on types of disaster and psycho-social impact of disaster, references are given at the end)

Content:

1. Psychosocial Impact of Disaster on Vulnerable Group

• Children
• Women
• Elderly
• Differently Able

1. Social Work Intervention with Survivors of Disaster
2. Conclusion
3. References 

1.            PSYCHOSOCIAL IMPACT OF DISASTER ON VULNERABLE GROUPS

Disasters do not affect everyone in the same way. At an individual level, some may experience a disaster with few or no psychological consequences, while others will go through the same disaster and be emotionally devastated. Beyond individual variation, certain categories of people are especially vulnerable or vulnerable in specific ways.

1.1         CHILDREN

Two myths are potential barriers to recognizing children’s responses to disaster and must be rejected: (1) that children are innately resilient and will recover rapidly, even from severe trauma; and (2) that children, especially young children, are not affected by disaster unless they are disturbed by their parents’ responses. Both of these beliefs are false. A wealth of evidence indicates that children experience the effects of disaster doubly.

Most children respond sensibly and appropriately to disaster, especially if they experience the protection, support, and stability of their parents and other trusted adults. However, like adults, they may respond to disaster with a wide range of symptoms. Their responses are generally similar to those of adults, although they may appear in more direct, less disguised form.

Among younger children, anxiety symptoms may appear in generalized form as fears (separation, strangers, animals, or sleep disturbances. They may withdraw socially or may lose previously acquired developmental skills (e.g., toilet training). Among the older ones, anxiety symptoms may appear in sleep disturbances, irritability, or aggressive behavior and angry outbursts may appear. Other changes in behaviour includes mood swing, obvious anxiety and fearfulness, withdrawal, loss of interest in activities, etc.

As children approach adolescence, their responses become increasingly like adult responses. Greater levels of aggressive behaviors, defiance of parents, delinquency, substance abuse, and risk-taking behaviors may be evident. School performance may decline. Wishes for revenge may be expressed. Adolescents are especially unlikely to seek out counselling.

1.2         WOMEN

Women’s roles and experiences create special vulnerability in the face of disaster. In poorer countries, women are more likely to die in disasters than men are. In richer countries, as well, women often show higher rates of post disaster psychological distress – depression, PTSD, and anxiety (Enrenreich, 2001). Several aspects of women’s experience of disaster may contribute to these results:

·         Women are often assigned the role of family caregivers. As such, they must stay with and assist other family members. This may affect their willingness to leave their homes when a disaster (such as a storm) threatens.

·         Women may be more isolated and home-bound due to their traditional roles. As a result, they may have less access to information (both before a disaster and after).

·         In the aftermath of disaster, women may face another threat: violence. This threat may take several forms like physical or emotional abuse from their spouse and sexual exploitation by other.

·         Women may also be exposed to rape and other forms of violence in shelters or refugee camps. In war situations, women and girls are extremely vulnerable.

·         Health care facilities in shelters and refugee camps often do not attend to women’s needs with regard to reproductive health, and providing for relief of other sources of strain on women, such as responsibilities for childcare, often get a low priority.

·         In the aftermath of disaster, women who have been widowed by the disaster may find it harder to remarry than men. Lacking skills that are saleable in the paid job market, they may be left destitute.

The experience of women in disaster, it should be emphasized, can create opportunities for women, as well. Women may have better social networks and hence, more social support than men. They may emerge as the leaders of grass-roots level organizations. They may be able to use disaster aid to develop skills and acquire tools and take on non-traditional roles.

1.3         THE ELDERLY

Reports on the responses of the elderly to disaster are inconsistent. In some disasters, they seem no more vulnerable than younger people. In others, they appear more vulnerable. Despite the inconsistency in formal research studies, there are reasons to believe that that the elderly are at increased risk for adverse emotional effects in the wake of disaster. They may live alone and lack help and other resources. Depression and other forms of distress among the elderly are readily overlooked, in part because they may not take on exactly the same symptom pattern as among younger people. For instance, disorientation, memory loss, and distractibility may be signs of depression in the elderly.

The elderly are also more vulnerable to being victimized. In the context of increased stress on the family and community, meeting their special needs may take on a lowered priority. One particular issue that may appear is feelings that they have lost their entire life (loss of children, homes, memorabilia) and that, due to their age, there is not enough time left in their life to rebuild and recreate.

1.4         THE DIFFERENTLY ABLED

Although people who are physically challenged and mentally ill or challenged have distinct needs from one another, all three groups are at especially high risk in disasters. For those in each group, the normal patterns of care or assistance that they receive and their own normal adaptations to produce acceptable levels of functioning are disrupted by disasters. For instance, supplies of medication, assistive devices such as wheelchairs, familiar caretakers, and previously effective programs of treatment may become unavailable. This has both direct effects and increases anxiety and stress. Stress, in turn, may exacerbate pre-existing mental illness. There may also be special needs with regard to housing or food.

Those who were mentally ill or developmentally delayed may also have fewer or less adaptable coping resources available and less ability to mobilize help for themselves. The ongoing problems of the disabled may seem to the other victims of the disaster to be of only minor importance in comparison to their own acute and unaccustomed suffering. Their disabilities may even seem like an obstacle to dealing with the disaster itself. The disabled are especially vulnerable to marginalization, isolation, and to “secondary victimization.” They are at greater risk of post-disaster malnutrition, infectious disease (e.g., in a shelter situation), and of the effects of lack of adequate health care.

2.            SOCIAL WORK INTERVENTION

Social Work practice can adopt various approaches in intervention with survivors of disaster. At the micro level, we can undertake psycho-social support of victims and do curative work, at the mezzo level, we can undertake preventive measures like community mobilization and capacity building, and at the macro level, we can intervene in better disaster mitigation and management programmes.

At the micro level, psycho-social support in the context of disasters refers to comprehensive interventions aimed to address a wide range of psychosocial problems arising in the aftermath of a disaster. These interventions help individuals, families and groups to restore social cohesion and infrastructure along with maintaining their independence and dignity. Psychosocial support helps in reducing the level of actual and perceived stress that may prevent adverse psychological and social consequences among disaster affected people

The role of a social worker in providing psycho-social support to survivors varies from one disaster phase to another. It is thus important to understand their phase specific roles in the aftermath of a disaster.

A. Immediate phase: At the aftermath of the disaster, the first major role is to reduce the distress of the people by helping them overcome their trauma and come to terms with their losses (material or life).  The second major role is to increase relief and the third major role is to establish linkages with resources.

B. Later phase: After the immediate phase of disaster is over, the next major role is the assessment of needs to ensure a holistic intervention. Interventions at this stage should focus on making people own the process and become equal partners in the entire rebuilding process right from planning to implementation. They should help survivors to ensure that the options are viable, sustainable and owned by the people. Regular monitoring should form an integral part of the needs assessment because it could bring out new issues that need to be addressed and lead to innovative intervention packages for better recovery and rebuilding. And, the final role is in referring a person to a specialist if the worker is not able to help the survivors to deal with their problems.

In order to make a holistic and beneficial intervention, the Social worker must adhere to some basic principles, values and understanding including;

• -          No one who experiences or witnesses the event is untouched by it
• -          Safety and material security underlie emotional stability
• -          Disaster stress and grief reactions are normal responses to an abnormal situation.
• -          Disaster results in two types of trauma i.e. individual and collective
• -          Interventions must be appropriate to the phase of disaster
• -          Interactions should be matched to the disaster phase
• -          Interventions must take people’s culture into account
• -          Direct interventions have an underlying logic
• -          Family and Social Support systems are crucial for recovery
• -          Recognize that there is a specially vulnerable group in the society
• 
  

The basic techniques adopted by social worker in providing psycho-social care to survivors of disaster are (Sanapathy, 2009):

a) Ventilation: ventilation is a process to help the disaster survivors in expressing their thoughts, feelings and emotions related to the disaster and the resulting living conditions. Beside survivors of disaster who are undergoing traumatic-stress disorder and PTSDs have urgent need to ventilate, so they should be allowed to do so as it is shown to be therapeutic to them.

b) Empathy: Looking at the event from the other person’s perspective and trying to realise the trauma of the other person by keeping himself/herself in that situation

c). Active Listening: Active listening is an important skill to facilitate ventilation and develop empathy, which in turn facilitate the whole process of providing emotional support.

d). Social support: In a disaster situation all the support systems get disrupted, hence the need to rebuild and restore. The rate at which the survivors will get over with the trauma of the events will highly depends on the kind of social support he or she gets, and also social support in any form is known to be therapeutic.

e). Externalization of Interests: Engaging survivors in small but productive activity/work would help them in imbibing a positive thinking and feelings. This technique is very crucial from the participatory community disaster management approach. This also helps the survivors in providing a channel to ventilate/express some of their repressed emotions and feelings. In addition this technique has a positive impact on their self-esteem and self-concept. Once they are engaged, their minds will be meaningfully occupied and the physical movement will also add to the increased level of feeling better and energized.

f). The Value of Relaxation: Introducing relaxation activities for children (for instance some games, songs, dancing, painting, colouring and other things) and adults involving physical movement has proved to be very beneficial in helping survivors recover from their trauma and pain. These activities will help to channelise their energy and control some stress producing hormone.

g). Turning towards Religion and Spirituality: Religious belief or belief in a higher power greater than man is an integral part of human beings’ existence and this gives great relief and support during critical periods of their lives. Similarly, spiritualism can also help in rebuilding shattered life gradually. Therefore, it is important to reinforce the religious practices and spirituality in the person we are working with because it has tremendous power to heal the pain and suffering.

Psychosocial and emotional care services deal with human emotions, thoughts and behaviours in situations when people are highly distressed due to their exposure to disaster consequences. It is important to understand that, providing this type of care services is not a charity or pity rather it is an essential aspect of the human rights of the survivors to live with dignity in disaster situations.

3.            CONCLUSION

India is a theatre of Disasters. Natural disasters are quite frequent in different parts of the country, be it earthquake, Tsunami, cyclone, flood, drought or land-slides. Further the human made disasters like industrial, chemical, fire, nuclear, riots, refugees, internally displaced persons and prolonged conflicts and other complex situations retard country’s overall development. These disasters are quite devastating and life threatening for the affected people.

Disasters have impacts on individuals, families and communities. These are not distinct, separable effects. The devastating effects of disaster on the individuals making up a family or a community play a major role in creating the family and community effects. Even more important, social support systems play an extremely important role in protecting individuals from the impact of the disaster and from the impact of stress in general. Social disruption both reduces and interferes with the healing effects of the family and the community and is itself an enormous source of stress on the individuals who make up the family or community. Disruption of the family or community may be more psychologically devastating, both in the short run and especially in the long run, than the disaster itself.

However, disaster tends to dehumanize the majority population, evident in the manner of their treatment of survivors.  This is most evident amongst the marginalized section of the society. For example, in every disaster in India, the medium of meeting the emotional needs of women usually is to arrange for their marriage.  Secondly, community participation in post-disaster rebuilding seems a goal unattained. The government always took over a parental role of doling out compensation and the community are pre-occupied with chasing after the compensation.  Thirdly, India does not have a framework for rehabilitation with a long-term perspective.  In most disasters, there is a massive upsurge of goodwill and material support at the acute phase, but once the acute phase is over, they are totally ignored.

India is a vast country and undeniably disaster prone, however, it must challenge why each and every disaster is allowed to cause the same amount/level of damages with every new disaster, again and again.

The most basic issue in psychosocial intervention following disasters is to transform those affected from being victims to survivors. What differentiates a victim from a survivor is that the former feels himself  subject to a situation over which he has no control over his environment or himself, whereas a survivor has regained a sense of control and is able to meet the demands of whatever difficulty confronts him. A victim is passive and dependent upon others; a survivor is not – he is able to take an active role in efforts to help his community and himself recover from the disaster (Ladrido-Ignacio & Perlas, 1995).

4.            REFERENCES

1.             British Psychological Society (1990): Psychological Aspects of Disaster; British Psychological Society, Leicester

2.             Cedar Rapids Counselling & Psychotherapy Group (2008): Phases of Disaster; Back to Business: Health Recovery – Stress Management, Cedar Rapid (AI)

3.             Centre for Research on the Epidemiology of Disasters (CRED): Technical Reference, Chapter 4. Disaster: Types and Impact, "Safer Homes, Stronger Communities: A Handbook for Reconstructing after Natural Disasters" published by the World Bank in January 2010.

4.             Ehrenreich, John H, (2001): Coping with Disaster: A Guidebook to Psychosocial Intervention (Revised Edition), Centre for Psychology and Society, State University of New York 

5.             Ladrido-Ignacio, L, & Perlas, AP, (1995): From victims to survivors: Psychosocial intervention in disaster management in the Philippines. International Journal of Mental Health, 24, pp. 3-51.

6.             Roa, MVS Srinivasa (2006): Chapter 5: Psycho-Social Consequences of Disaster in Disaster Management, Oxford Press, New Delhi

7.             Satapathy, Sujata (2009): Psychosocial Care in Disaster Management: A Training of Trainers Module; National Institute of Disaster Management, Ministry of Home Affair, GOI, New Delhi

8.             WHO (1992): Psychosocial Consequences of Disabilities: Prevention and Management”. WHO/MNH, PSF/91.3, Rev. 1

INTERNET

1.      David Baldwin’s Trauma Pages, http://www.trauma-pages.com

2.      Disaster Management, http://www.en.wikepedia/disastermanagement

3.      Disaster Mental Health Institute, http://www.ncptsd.org

4.      International Society for Traumatic Stress Studies (ISTSS). http://www.istss.org

5.      National Centre for PTSD, http://www.dartmouth.ed/dms/ptsd

Psycho-Social Impact of Natural Disaster

(This is part of my assignment on types of disaster and psycho-social impact of disaster, references are given at the end)

1. Impact of Disaster

2. Social Impact of Disaster

3. Psychological Impact of Disaster

4. Psychosocial Impact of Disaster

1. IMPACT OF DISASTER
Disaster impacts comprise physical, health, economic, social and psychological impact. This paper focuses on the psycho-social aspect, so before we go into the details, let’s take a look at the other kind of impact (i.e. physical, health and economic aspect) that a disaster can have.

• The physical impacts of disasters include casualties (deaths and injuries) and property damage which leave the survivor homeless, and both vary substantially across hazard agents. The physical impacts of a disaster are usually the most obvious, easily measured, and first reported by the news media. 
• Health Impacts of disaster lies in the number of injuries which occur from the event itself, and which followed later on in the form of different virus and diseases. In the short-term, the major health concern is on the injured, and the disturbances of supply of basic amenities like clean drinking water, food, medicines, medical treatment, etc. to prevent an outbreak of diseases. In the long-run, the major health concerns include provision of health facilities, exposure to the environment due to lack of proper shelter and clothing, and an outbreak of malnutrition and famine due to the disaster.
• Economic Impacts of disaster will include loss of property and economic establishments like shops, farms etc., damaged social infrastructure, loss to trade and business, and disturbance to livelihood activities.

1.1 COMMUNITY OR SOCIAL IMPACT OF DISASTER
Disasters directly affect their individual victims. But beyond that disasters create tears in the tissue of social life. Sometimes this is direct and total, as when disaster forced people to leave their land and migrate elsewhere. In other cases, the rapid influx of helpers, the presence of government officials, press, and other outsiders (including mere curiosity seekers), and the flood of poor people from outside the disaster area into a disaster area seeking their own share of the food and other supplies relief agencies are providing to disaster victims, combine to further disrupt the community.
Even when the formal structure of a community is maintained, the disaster can disrupt the bonds holding people together, in families, communities, work groups, and whole societies. When those bonds are destroyed, the individuals comprising the affected groups lose friends, neighbours, a community, a social identity. These collective effects of disaster may ultimately be as devastating as the individual effects. The consequences of disaster for families, neighborhoods, communities, and societies are many:

• Change in Family Dynamics: Disaster-produced deaths or disabilities, family separations, and dependency on aid givers and intervention by outsiders that may upset or challenge traditional child rearing practices, traditional patterns of male-female relationships, traditional line of authority and hierarchy, or in simple term, may force people out of traditional roles or into new ones.
• Increase in Family/Community Violence: In the wake of disaster, marital conflict and distress rises; increases in marital conflict, parent-child conflicts, intra-family violence (child abuse, spouse abuse) are reported to be rampant.
• Change in Community Dynamics: Disasters may physically destroy important community institutions, such as schools and institutions, and traditional patterns of authority are disrupted along with customary social controls on individual behaviour. Disasters can also disrupt the ability of communities to carry out customary or traditional livelihood activities central to people’s individual, community, and social identity, ranging from work and recreational activities to accustomed rituals.
• Change in Societal Role Dynamics: Disasters place a strain on traditional community social roles, patterns of social status, and leadership. In the wake of disaster, new leaders may emerge in a community, due to the role of these people in responding to the disaster.
• Increase in Anti-social Elements: Several studies have shown an increase in the rates of community violence, looting, riots, agitation, aggression, drug and alcohol abuse, and rate of legal convictions in the wake of disaster.
• Change in Community Source of Livelihood: Disasters disrupt the ability of communities to carry out customary or traditional livelihood activities. Some of these disruptions are temporary, but others are hard to reverse. This may be limited to personal possessions or may lead to permanent loss of tools, animals, and land.
• Change in Productive patterns: Disaster may lead, directly or indirectly, to permanent changes in productive patterns, especially patterns of land ownership and use. Shifts from subsistence agriculture to wage labor, land looting, migration and uprooting and resettlement play a role.
• Change in Community Cohesion: Schisms may appear in a community, as cohesion is lost. One danger is that of scape-goating, either of individuals or using traditional divisions in the community (e.g., along religious or ethnic lines).

The social impact of disaster can progress at a very slow pace and develop over a long period of time and can be difficult to assess when they occur. Despite the difficulty in measuring these social impacts, it is nonetheless important to monitor them, and even to predict them if possible, because they cause significant problems for the long-term functioning of specific types of households and individual member of an affected community.

1.2 PSYCHOLOGICAL IMPACT OF DISASTER
Living in a disaster area can be highly stressful. Staying in damaged buildings, relocating to shelters, dealing with the death or injuries of loved ones, as well as the prolonged time and energy involved in recovering from the affects of the disaster can result in feelings of anxiety and depression. Disaster is known to cause a wide range of negative psychological responses in the victims including:

• - psychophysiological effects such as fatigue, gastrointestinal upset, and tics;
• - cognitive effects such as confusion, impaired concentration, attention deficits;
• - emotional effects such as anxiety, depression, and grief;
• - behavioural effects such as changes in sleep and appetite, substance usages;

Although the precise figures vary from situation to situation, up to 90% or even more of victims can be expected to exhibit at least some untoward psychological effects in the hours immediately following a disaster. In most instances, symptoms gradually subside over the weeks following. By twelve weeks after the disaster, however, 20% to 50% or even more may still show significant signs of distress. The number showing symptoms generally continues to drop, but delayed responses and responses to the later consequences of disaster continue to appear. While most victims of disasters are usually relatively free of distress by a year or two after the event, a quarter or more of the victims may still show significant symptoms while others, who had previously been free of symptoms, may first show distress a year or two after the disaster. Anniversaries of the disaster may be especially difficult times for many survivors, with temporary but unexpected reappearance of symptoms which they had thought were safely in the past (Ehrenreich, 2001).
The extraordinary prevalence of such strong physiological, cognitive, and emotional responses to disasters indicates that these are normal responses to an extreme situation, not a sign of ‘mental illness’ or of ‘moral weakness’. Nevertheless, the symptoms experienced by many victims in the days and weeks following a disaster are a source of significant distress and may interfere with their ability to reconstruct their lives. If not addressed and resolved relatively quickly, such reactions can become ongoing sources of distress and dysfunction, with devastating effects for the individual, their family, and their society.

1.3 PSYCHOSOCIAL CONSEQUENCES OF DISASTER
To what extend the disaster will be affect the victims will depend on the context of the individual’s social support system. Secure, supportive relationships are essential for the victims’ processing of the events and the eventual recovery. Those who have no close and supportive social environment are more vulnerable whereas those who are in a supportive environment can more easily cope with the situation.
Psycho-social coping with disasters depends upon the ability of the victims to adjust psychologically, the capacity of community structures to adapt to crisis, and the help available to the victims. The most common psycho-social consequences of disasters are:
(a) Cauldron of Emotions
A cauldron of emotional reactions can come to the boil after a disaster. Beginning with numbness, traversing elation, and relief for having survived, the victims will eventually ride up an ‘anxiety escalator’. Common post-disaster reactions include flashbacks, nightmares, involuntary triggering of memories, panic attacks, etc, often culminating in a proactive ‘avoidance response. Normally, this psycho-social impact of disaster settles down within the first weeks, however, if they remain protracted and intense, they represent a post-traumatic stress disorder .
(b) Disaster Syndrome
The disaster syndrome, as currently known and understood in the social sciences disaster literature, is the human condition characterized by ‘stunned psychological incapacitation’, ‘shock’, and ‘immobility, inability to act rationally, and inability to take care of oneself or others’ in the aftermath of a disaster. This “psychological shock” following disaster impact affects ‘only a small proportion of people’ and when it occurs, the condition is usually ‘short lived, say the sources. In major disaster with high casualty rate, disaster syndrome is often seen in about 25% to 75% of the victims in the first week, but significantly dropped within 10 weeks.
(c) Grief Reactions
Grief is a multi-dimensional syndrome, it can be for love ones, home, treasured possessions, livelihood, or community. The severity of the morbidity is greater when it is associated with personal loss. The emotional reactions of grief include sadness, distress, and anger as well as longing and yearning. Grief reactions usually tape off in 4-6 weeks and recurrences are induced by anniversaries. Psychological morbidity among the bereaved is aggravated by a weak social support systems, particularly in the case of women who have lost children. Intense grief reactions, in fact, can become chronic and lead to severe depression.
These psychological and practical obstacles to a ‘normal’ grief reaction or response to the death of a loved one may contribute to a feeling of lack of closure or permit magical fantasies that the deceased person has not, in fact, died. Any of several abnormal bereavement syndromes may appear[1].

• Inhibited Grief: The bereaved exhibits a pattern characterized by psychic numbing, over-control and containment of emotions, little display of affect. They may be seen as “coping well,” yet this pattern is associated with later depression and anxiety.
• Distorted Grief: The bereaved shows intense anger and hostility which dominate over their sadness and guilt. This anger may be directed at anyone the bereaved associates with the deceased’s death (e.g., relief workers).
• Chronic Grief: The feelings of sadness and loss do not dissipate. Frequent crying, pre-occupation with the loss are unremitting.
• Depression: The bereaved lapses into depression, with prolonged grief, despair, and a sense that life is not worth continuing. Sleep and appetite disturbances may appear. The bereaved may have active fantasies of being reunited with the deceased and suicidal ideation or attempts may occur.
• Excessive Guilt: The bereaved may show excessive self-recrimination and guilty pre-occupations, which eclipse their sadness. Self destructive, yet not overtly suicidal behaviors, such as frequent accidents or excessive drinking may occur.

(d) Post-Traumatic Stress Disorder (PTSD)
Battle fatigue like feeling typically numb at first but later, depression, excessive irritability, recurrent nightmares, flashbacks to the traumatic scene, over reaction to sudden noises, feeling of guilt because significant others are dead while the individual is still surviving are some sign that the survivor is under Post-Traumatic Stress Disorder. The characteristic symptoms of Post Traumatic Stress Disorder include:

• Persistent re-experiencing of the traumatic event: Recurrent and intrusive recollections of the events of the disaster; recurrent distressing dreams in which the disaster is replayed; intense psychological distress or physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event; or experiences in which the victim acts or feels as if the event is actually re-occurring.
• Persistent avoidance of stimuli associated with the trauma and continued numbing of general responsiveness: Efforts to avoid thoughts or feelings or conversations about the disaster; efforts to avoid activities, places, or people that remind the victim of the trauma; inability to recall important parts of the disaster experience; markedly diminished interest or participation in significant activities; feelings of detachment or estrangement from others; restricted range of affect; or a sense of a foreshortened future, without expectations of a normal life span or life.
• Persistent symptoms of increased arousal: Difficulty falling or staying asleep; irritability or outbursts of anger; difficulty concentrating; hyper-vigilance; exaggerated startle response.

This general cluster of symptoms has been reported in every part of the world. In less industrialized parts of the world and among people coming from these areas, the avoidance and numbing symptoms have been reported to be less common and dissociative and trance-like states, in which components of the event are relived and the person behaves as though experiencing the events at that moment, may be more common.

(e) Post-Traumatic Syndrome (Post-Traumatic Depression)
Psychological effects of the disaster may persist for many months; from acute phase if they move onto chronic phase, they tend to suffer from posttraumatic syndrome. Though the symptoms of posttraumatic syndrome generally appear soon after the trauma, in some cases there is an “incubation period”. Some of the important symptoms are: difficulty in falling or staying sleep, Irritability or outbursts of anger, difficulty in concentration, hyper vigilance, exaggerated startle response almost similar to panic attack, etc.

Post Traumatic Depression: Protracted depression is one of the most common findings in studies of acutely or chronically traumatized people. It often occurs in combination with Post Traumatic Stress Disorder. Trauma can produce or exacerbate already existing depression. Common symptoms of depression include sadness, slowness of movement, insomnia (or hypersomnia), fatigue or loss of energy, diminished appetite (or excessive appetite), difficulties with concentration, apathy and feelings of helplessness, anhedonia (markedly diminished interest or pleasure in life activities), social withdrawal, guilty ruminations, feelings of hopelessness, abandonment, and irrevocable life change, preoccupations with loss, and irritability. In some cases, the person may deny being sad or may complain, instead, of feeling “blah” or having “no feelings.” Some individuals report somatic complaints, including widespread aches and pains, rather than sadness. Suicidal ideation or attempts may appear. With children, somatic complaints, irritability, social withdrawal are particularly common.

In some cultures, depression may be experienced largely in somatic terms, rather than in the form of sadness or guilt. Complaints of “nerves”, headaches, generalized chronic pain, weakness, tiredness, “imbalance,” problems of the “heart,” feelings of “heat,” or concerns about being hexed or bewitched may appear.

(See my next post for the other part of this assignment)

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[1] Note: Different cultures vary widely with respect to the ‘expected’ reaction in situation of grief. [For further information on this, please refer to John H Enrenreich’s Coping with Disaster.

Categories of Victims and Phases of Disaster

(This is part of my assignment on "types of disaster and psycho-social impact of disaster", references are given at the end)

1. Categories of Victims of Disaster

2. Phases of Disaster

1. CATEGORIES OF VICTIMS OF DISASTER

Almost everyone in the population is affected by a disaster. No one is untouched by it. Those who suffer damage are called victims. The victims may die or live. Those who manage to live are called survivors. These survivors can be classified as follow (CRED, 2010):

VICTMS	DEFINITIONS & EXAMPLES
Primary Survivor	One who is exposed to the disaster first-hand and then survives. They are called ‘survivor victims’. Intervention is primarily for them since they are the most highly impacted amongst the victims. Survival guilt (“why don’t I die with my family?”) is very high among primary survivor.
Secondary Survivor	One who grieves the loss of primary victims, Eg. A mother who lost her child, or a man who lost his friend. Self-blame (“I should have done this”) is common among secondary survivor.
Third Level Survivor	The rescue and relief personnel who are exposed to the devastation and sufferings of people are also highly affected by the disaster. They undergo almost the same mental trauma as the other victims.
Fourth Level Survivor	Reporters, government personnel, traders, etc.
Fifth Level Survivor	People who read about or see the event in media reports.

2. PHASES OF DISASTER

Disasters are not totally discrete events. Their possibility of occurrence, time, place and severity of the strike can be reasonably and in some cases accurately predicted by technological and scientific advances. It has been established that there is a definite pattern in their occurrences and hence we can to some extent reduce the psychosocial impact of damage though we cannot reduce the extent of damage itself.

There are a number of disaster phases that have been identified by mental health professionals (CRACC, 2008). Each of these phases is associated with emotional and behavioural elements, although there is often overlap.

(i) Pre-disaster Warning: The length of this phase depends on the event. For flooding, there are usually several days of warning that give people time to prepare, but for tsunami the warning might be short, while earthquake may not come with a warning.

(ii) Impact/Inventory (within hours): People may be temporarily stunned or confused as the disaster strikes, but they quickly recover and focus on protecting themselves and those close to them. Emotions include fear, helplessness, loss, dislocation, and feeling responsible ("I should have done more"). The inventory phase immediately follows the event as people start forming a preliminary picture of individual and community conditions. Emotions are wide-ranging as the extent of the impact is realized.

(iii) Heroic (up to 1 – 2 weeks): Throughout these first phases and afterward, people are responding to demands for heroic action to save the lives and property of others. Altruism is prominent. And people are willing to put forth major energy to help others survive and recover.

(iv) Honeymoon (1 – 24 weeks): This phase generally extends from one week to six months after the disaster. For those most directly affected, there is a strong sense of having shared with others a dangerous, catastrophic situation. For the community, there is a sense of cohesion and working together to recover. Relief efforts are in full swing, and hopes of a quick recovery run high. The emotions associated with this phase range from gratitude and hope to grief and continued disbelief.

(v) Disillusionment (2 months – 2 years): This phase can last from two months up to two years. The realities of recovery set in, and people experience feelings of disappointment, frustration, anger, resentment and bitterness if setbacks occur and promises of assistance are not fulfilled or are seen as too little, too late. Outside relief agencies and volunteers leave and some local community groups may weaken. Those most directly affected realize they have much to do themselves and their lives may never be the same. The ‘shared community’ feeling may gradually be lost as people concentrate on rebuilding their own lives and solving individual problems. Emotions are likely to include self-doubt, loss, grief, and isolation.

(vi) Coming to terms/Reconstruction (2 -5 and Lifetime): This phase generally lasts for several years after the disaster. Survivors focus on rebuilding their homes, businesses, farms and lives. The appearance of construction and new buildings, and development of new programs and plans bolster residents' belief and pride in community and in their own individual abilities to rebuild. But this process can be marked by ups and downs as anniversary and other events trigger emotional reactions, and if signs of progress are delayed.

It is important to understand the various phases of disaster because adopting the most appropriate approach right after the onset of disaster can make a big difference in the long-term, especially in the sphere of dealing and coping with the psycho-social impact.

TYPES OF DISASTER

(This is part of my assignment on types of disaster and psycho-social impact of disaster, references are given at the end)

1. Introduction

2. Concept of Disaster

3. Types of Disaster

1. INTRODUCTION

Disaster is a phenomenon that causes huge damage to life, property and destroys the economic, social and cultural life of people. It is a tragic event with great loss stemming from events such as earthquakes, floods, catastrophic accidents, fires, riots or explosions.

Every disaster results in deaths and injuries, damages and destructions, which are always visible. What are not always visible are the mental agony, trauma and stress of the survivors who have suffered losses of their near and dear or sustained damages of their assets and property.

Often such invisible impacts of disasters escape the notices of decision makers as well as rescuers till the affected people crowd the hospitals or suicide rates go up. Often such distress has continued for long after the initial outpouring of goodwill and charity of the general public and attention of media had died down, and even after the physical damages have been restored and reconstructed. Early recognition and proper intervention could have prevented many such prolonged agonies.

Today, there has been recognition of the need and importance of psychosocial intervention in the aftermath of a disaster. This has encouraged innovative research and practices that contributed to the knowledge base in disaster management more than ever before.

This paper will attempt to explain the concept of disaster and explain in details the various types of disasters. Then it will analyse the psycho-social impact of disaster on the individual, family and the community, and conclude with what kind of social work intervention can be undertaken.

2. CONCEPT OF DISASTER

- Disaster is “any occurrence that causes damage, ecological disruption, loss of human life, deterioration of health and health services, on a scale sufficient to warrant an extraordinary response from outside the affected community or area” (WHO, 1992)

- Disaster means a catastrophe, mishap, calamity or grave occurrence in any area arising from natural or manmade causes, or by accident or negligence which results in substantial loss of life or human suffering or damage to, and destruction of property or damage to/degradation of environment and is of such a nature of magnitude as to be beyond the coping capacity of the community of the affected area (DM Act 2005, GOI).

Disaster is a serious disruption of the functioning of a society, causing widespread human, material, or environmental losses which exceed the ability of the affected society to cope using only its own resources.

Thus, by definition itself, there cannot be a perfect ideal system that prevents damage, because then it would not be a disaster. It has to suffocate our ability and capacity to recover. Only then it can be called as disaster.

In contemporary academia, disasters are seen as the consequence of inappropriately managed risk. These risks are the product of a combination of both hazard/s and vulnerability. Hazards that strike in areas with low vulnerability are not considered a disaster, as is the case in uninhabited regions. For instance, a mud-slide in the jungle of the Amazon may not be a disaster, but a mud-slide in the poverty-stricken slum clusters of Mumbai definitely is a disaster.

Hazard refers to any phenomenon, substance or situation that has the potential to cause disruption or damage to infrastructure and services, people, property and environment. Capacity is the resources and skills people possess, and can be develop, mobilize and access that will allow them to have more control over shaping their own future and coping with disaster risks. Vulnerability is a concept that describes factors or constraints of an economic, social, psychological, physical and geographic nature, which reduce the ability of a community to prepare for and cope with the impact of hazards. Risk is the probability that negative consequences may arise when hazards interact with vulnerable areas, people, property and environment.

The damages caused by disasters are immeasurable and varies with the geographical locations, climate and the degree of vulnerability. Those related to weather and the earth’s geology like tsunami, earthquake, hurricane, cyclone, flood, etc. are the most widely recognized. However recent events like Fukishima Nuclear Leak in Japan (2011) and the Godhra Communal riot in Gujarat (2002), etc., point out that the sources and kind of damages are more complicated.

3. TYPES OF DISASTER

It is important to understand various kinds of disasters because depending upon the actual nature of disaster, the immediate reaction needs to be different. Understanding of each kind of disaster might also help in identifying the onset of a disastrous event, so that appropriate actions can be undertaken at all stages which could have a major impact on the final outcome in terms of amount of final loss.

Disasters are classified in various ways. Based on the time it takes to strike, disasters may occur suddenly (sudden disaster) like earth-quake and tsunami, or they may develop over a period of time (a slow onset) like climate change, famines caused by years of drought. However, disasters are commonly categorized by their origin –natural disaster and man-made disaster. Based on the scale of devastation and damage it caused, natural and man-made disasters are further classified into major/minor natural disaster and major/minor man-made disaster.

3.1 Natural Disaster

Natural disasters are primarily natural events. It is possible that certain human activities could maybe aid in some of these events, but, by and large, these are mostly natural events. A natural disaster is a consequence when a natural calamity affects humans and/or their built environment.

Among various natural hazards, earthquakes, landslides, floods and cyclones are the major disasters adversely affecting very large areas and population in the Indian sub-continent. These natural disasters are of (i) geophysical origin such as earthquakes, volcanic eruptions, land-slides and (ii) climatic origin such as drought, flood, cyclone, locust, forest fire, etc.

Natural Disasters can be broken into different categories based on its origin and cause as given in the table below.

CATEGORIES	DEFINITIONS & EXAMPLES
Geophysical Disasters	Those events originating from solid earth, e.g. earth-quake, volcano, landslide, etc.
Hydrological Disasters	Those events caused by deviations in the normal water cycle and/or overflow of body of water caused by wind set-up. Eg. flood, storm, coastal flood, etc.
Meteorological Disaster	Those events caused by short-lived/small to meso-scale atmospheric process (in the spectrum from minutes to days). Eg. tropical cyclone, hurricane, storm, tornado, etc
Climatological Disaster	Those events caused by long-lived/meso- to macro-scale processes (in the spectrum from intra-seasonal to multi-decadal climate variability). Eg. heat wave, cold wave, drought, etc.
Biological Disaster	Those disaster caused by the exposure of living organisms to germs and toxic substances, Eg. epidemic, plague, diseases, insect infestation, etc.

Source: CRED (2010)

For some type of natural disaster, it is possible to predict disaster to some extent, however it is not possible to control nature and to stop the development of natural phenomena but efforts could be made to avoid disasters and alleviate their effects on human lives, infrastructure and property through disaster management.

3.2 Man-made Disaster

Anthropogenic hazards or man-made disaster can come to fruition in the form of a man-made disaster. In this case, "anthropogenic" means threats having an element of human intent, negligence, or error; or involving a failure of a man-made system. This is opposed to natural disasters resulting from natural hazards.

Man-made disasters cover a wide range of events created largely due to accidents, negligence or sometimes even by human design, which result in huge loss of lives and property every year all over the world. These include road, rail, river, marine and aviation accidents, oil spill, building and bridge collapse, bomb blast, industrial and chemical accidents etc. These also include the threats of nuclear, biological and chemical disasters.

Man-made disaster can be divided into different categories viz. sociological disaster, technological disaster, transportation disaster and hazardous or CBRNs disaster.

CATEGORIES	DEFINITIONS & EXAMPLES
Sociological Disaster	It includes those disasters like war, civil disorder, communal riots, crimes, arson and terrorism
Technological Disaster	It includes those disasters like industrial accidents, fire, structural collapse, etc.
Transportation Disaster	It includes those disasters related to accident of train, aeroplane, ship, etc.
Hazardous or CBRNs Disaster	It includes those disasters related to chemical, biological, radiological and nuclear (CNRN) accidents

Source: CRED (2010)

The extent of damage caused by man-made disasters varies greatly and while this is the case, it is important to state that others have notably high costs when compared to others. This is especially true when it comes down to responding and recovering. Additionally, there are different factors which influence the costs such as location. For instance, if this were to occur in densely populated but wealthy countries, the end result might prove to be huge. However, if the same were to occur in densely populated but poor countries, the after effect costs might prove to be lower and this is in part closely tied to insurance.